Cerumen, Hearing, and Cognition in the Elderly

Moore, Ann M.; Voytas, John; Kowalski, Debra; Maddens, Michael

doi:10.1097/00130535-200205000-00003

Cited by 3 publications

(14 citation statements)

References 19 publications

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“…This frequency was quite low compared with Western countries. [2][3][4]10 The prevalence of wet type cerumen in the present study was 25.5%, and the incidence of wet cerumen with impaction and wet cerumen without impaction was not significantly different. The cause of a non-significant incidence of wet cerumen impaction in the present study might be due to the low participants.…”

Section: Discussionmentioning

confidence: 45%

“…8,9 Moore et al reported significant improvement of hearing and MMSE score after cerumen removal. 10 Similarly, Oron et al reported a significant difference in participants' Raven's Standard Progressive Matrices Test scores before and after cerumen removal.…”

Section: Discussionmentioning

confidence: 94%

“…[2][3][4][5][6] Moore et al reported that 65.6% of residents in a skilled nursing facility had cerumen impaction in at least one ear. 10 The reason for a higher prevalence of cerumen impaction in people with an intellectual disability is still unknown. Several possibilities include poor hygiene and anatomical abnormalities of the ear canal, such as stenosis with Down syndrome, were suggested as possible causes.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Moore et al studied the influence of cerumen impaction clearance on Mini-Mental State Examination (MMSE) performance. 10 In their study, 65.5% of the participants had cerumen in at least one ear, and hearing and the MMSE score improved significantly in participants with impacted cerumen after cerumen removal. In an earlier study, we reported that cerumen impaction of the better-hearing ear (BHE) was observed in 10.7% of community-dwelling Japanese older adults aged older than 60 years.…”

Section: Introductionmentioning

confidence: 89%

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Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment

Sugiura¹,

Yasue²,

Sakurai

et al. 2014

Geriatrics Gerontology Int

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Aim:To assess the effect of cerumen impaction and its removal on hearing ability and cognitive function in elderly patients with memory disorders in Japan.Methods: Pure tone audiometry (PTA) and the Mini-Mental State Examination (MMSE) were administered to participants before and after cerumen removal. Participants who had cerumen impaction in the better-hearing ear comprised the case group; the control group consisted of participants who either did not have cerumen impaction or had it in the worse hearing ear. Hearing and cognition changes were compared between the groups after cerumen removal.Results: A total of 55 patients who completed all examinations were assigned to the case group (29 patients) or the control group (26 patients). The average hearing change was 4.6 ± 7.4 in the case group and 0.9 ± 0.9 in the control group (P = 0.029). The average change in MMSE score was 0.7 ± 2.5 in the case group and −1.0 ± 4.1 in the control group (P = 0.068). The case group showed a significant improvement in MMSE scores after age adjustment compared with the control group (P = 0.049). Conclusion:Hearing improved significantly in the case group relative to controls after cerumen removal. A significant cognitive improvement in the case group relative to controls was additionally observed after cerumen removal with age adjustment. Thus, the present results suggest routine ear canal examinations might benefit elderly individuals with memory disorders. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 56-61.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

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Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment

Sugiura¹,

Yasue²,

Sakurai

et al. 2014

Geriatrics Gerontology Int

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“…13 Moreover, excessive or impacted cerumen in high-risk populations, such as the elderly and developmentally delayed, is underdiagnosed and likely undertreated. 10,14,15 The target patient for this guideline is over 6 months of age with a clinical diagnosis of cerumen impaction.…”

Section: Introductionmentioning

confidence: 99%

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary

Schwartz

Magit²,

Rosenfeld

et al. 2017

Otolaryngol.--head neck surg.

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The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated Clinical Practice Guideline: Earwax (Cerumen Impaction). To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations emphasize proper ear hygiene, diagnosis of cerumen impaction, factors that modify management, evaluating the need for intervention, and proper treatment. An updated guideline is needed due to new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials) and the need to add statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care. Differences from Prior GuidelineThis clinical practice guideline is as an update, and replacement, for an earlier guideline published in 2008 by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF).1 An update was planned for 5 years after the initial publication date and was further necessitated by new primary studies and systematic reviews that might suggest a need for modifying clinically important recommendations.2 Changes in content and methodology from the prior guideline include the following: addition of a consumer advocate to the guideline update group (GUG); 3 guidelines, 5 systematic reviews, and 6 randomized controlled trials (RCTs); emphasis on patient education and counseling with new explanatory tables; expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; enhanced external review process to include public comment and journal peer review; new algorithm to clarify decision making and action statement relationships; and 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.

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Clinical Practice Guideline (Update): Earwax (Cerumen Impaction)

Schwartz

Magit

Rosenfeld

et al. 2017

Otolaryngol.--head neck surg.

100

119

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Objective. This update of the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation cerumen impaction clinical practice guideline provides evidencebased recommendations on managing cerumen impaction. Cerumen impaction is defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. Changes from the prior guideline include• a consumer added to the development group;• new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials); • enhanced information on patient education and counseling; • a new algorithm to clarify action statement relationships;• expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; • an enhanced external review process to include public comment and journal peer review; and • 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.Purpose. The primary purpose of this guideline is to help clinicians identify patients with cerumen impaction who may benefit from intervention and to promote evidence-based management. Another purpose of the guideline is to highlight needs and management options in special populations or in patients who have modifying factors. The guideline is intended for all clinicians who are likely to diagnose and manage patients with cerumen impaction, and it applies to any setting in which cerumen impaction would be identified, monitored, or managed. The guideline does not apply to patients with cerumen impaction associated with the following conditions: dermatologic diseases of the ear canal; recurrent otitis externa; keratosis obturans; prior radiation therapy affecting the ear; previous tympanoplasty/myringoplasty, canal wall down mastoidectomy, or other surgery affecting the ear canal.Key Action Statements. The panel made a strong recommendation that clinicians should treat, or refer to a clinician who can treat, cerumen impaction, defined as an accumulation of cerumen that is associated with symptoms, prevents needed assessment of the ear, or both.The panel made the following recommendations: (1) Clinicians should explain proper ear hygiene to prevent cerumen impaction when patients have an accumulation of cerumen. (2) Clinicians should diagnose cerumen impaction when an accumulation of cerumen, as seen on otoscopy, is associated with symptoms, prevents needed assessment of the ear, or both. (3) Clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as ≥1 of the following: anticoagulant therapy, immunocompromised state, diabetes mellitus, prior radiation therapy to the head and neck, ear canal stenosis, exostoses, and nonintact tympanic membrane. (4) Clinicians should not routinely treat cerumen in patients who are asymptomatic and whose ears can be adequately examined. (5) Clinicians s...

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Cerumen, Hearing, and Cognition in the Elderly

Cited by 3 publications

References 19 publications

Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment

Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction)

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